Mental health includes our emotional, psychological, and social well-being, and determines how we make choices, handle stress, and relate with others. People with “good” mental health don’t always feel happy or never feel lonely, but rather have the tools to cope with stress, trauma, and adversity.
Mental health is an essential part of overall health, and interacts with physical health in many ways. For example, some mental illnesses increase the risk of physical conditions (for example, depression increases the risk of stroke) and some chronic health problems can increase the risk of mental illness. It is important to take your mental health as seriously as you take your physical health.
What is mental illness?
Mental illnesses are conditions that affect a person’s thinking, feeling, mood, or behavior, and may impact a person’s daily functions and their ability to relate with others. They can be short term, episodic (on and off with clear starting and ending points), or long-lasting. They are not caused by one single factor, but are influenced by:
- Biological factors, like genes or brain chemistry
- Life experiences, such as trauma or abuse
- Family history of mental health problems
Mental illnesses are NOT caused by weakness, laziness, or any other moral failing. It is not your fault if you have a mental illness. The good news is that mental illness is treatable, just like a physical illness, and recovery is possible. If you think you (or someone you know) might have a mental illness, it is best to consult a professional as soon as possible. A health care professional will connect the symptoms and experiences you are having to help formulate a diagnosis.
Mental Illness Among Adolescents
Mental illness is very common among adolescents and young adults: 1 in 5 young people suffer from a mental illness. Being a teenager is an overwhelming time– your body and brain go through physical changes, you must navigate new social environments, and you are expected to take on increasing responsibilities at school and at home. For many, these pressures and problems can lead to one or more of a variety of mental health conditions. It is around this age that many mental health conditions develop: around 50% of lifelong mental illnesses begin by age 14 and 75% begin by age 24.
If you are experiencing feelings of sadness or hopelessness, you are not alone. According to Maryland data from the Youth Risk Behavior Survey, in Howard County in 2018:
- 28.4% of high school students reported feeling sad or hopeless in the past year
- 24.2% of middle school students reported feeling sad or hopeless in the past year
- 16.5% of high school students and 23.0% of middle school students seriously considered attempting suicide
Warning Signs of Mental Illness
If you think you, or someone you know, may have a mental health condition, it’s important to know and recognize the 10 common warning signs that you should seek help.
- Feeling very sad or withdrawn for more than two weeks.
- Seriously trying to harm or kill oneself or making plans to do so.
- Severe out-of-control, risk-taking behaviors.
- Sudden, overwhelming fear for no reason.
- Not eating, throwing up or using laxatives to lose weight; significant weight loss or weight gain.
- Seeing, hearing or believing things that are not real.
- Repeated usage of drugs or alcohol.
- Drastic changes in mood, behavior, personality or sleeping habits.
- Extreme difficulty in concentrating or staying still.
- Intense worries or fears that get in the way of daily activities.
If you are experiencing one or more of these symptoms, find a trusted adult and reach out for help. Remember, your mental health is as important as your physical health and you deserve to get help and feel better. There are many different mental health conditions that affect people in different ways. For a breakdown of symptoms, treatments, and resources for different conditions, check out the National Alliance of Mental Illness.
In a Crisis
Finding Mental Health Support
If you are in a non-crisis situation, there are many ways you can get support. The first is to reach out to a trusted adult. Whether that is a parent or guardian, teacher, coach, faith leader, or anyone else, it is important to let that person know that you (or a friend) need help.
If you are experiencing mental illness, you deserve to get help and feel better, but it is not always easy to ask for help. For some ideas on how to start this conversation with a trusted adult, read Mental Health America’s guide to asking for help.
Once you have connected with your trusted adult, there are several steps that you can take together.
- Talk to your primary care provider or PCP (your regular doctor, nurse practitioner, or physician’s assistant). Your PCP can help you understand the feelings and symptoms you are experiencing and can refer you to a mental health professional.
- Take advantage of school-based mental health services. The Howard County Public School System (HCPSS) has school counselors, school psychologists, and school social workers to support its students. If you are interested in utilizing these resources, contact your student services office (find your school’s website, then go to “Student Services” or “Staff” to find a staff member to reach out to). For more information, check out the HCPSS website here.
- Find a mental health professional. Finding a team of professionals to support your recovery is essential to getting better. Your primary care provider is a great place to start in connecting you to the care you need. Below are some tips to help you connect to a mental health professional in Howard County:
Research what type of mental health professional is best for you. There are many different types of helping professionals, from mental health counselors, licensed social workers, psychologists, psychiatrists, and more. Check out Mental Health America’s guide to Finding the Right Mental Health Care for You.
Coordinate with your family’s health insurance. With your parent/guardian’s help, figure out what mental health services are covered by your plan, if you need a referral from your PCP, and identify in-network providers. For more information on this process, visit the Resources for Adults page.
Find a professional in Howard County. Here is the Howard County Youth Behavioral Health Directory.
This is a list of licensed counselors, social workers, psychologists and psychiatrists in Howard County that serve teens. This directory contains information on the services each practice provides, the forms of insurance they take, and which languages they offer. Here are some helpful definitions to help you navigate the directory:
- Outpatient treatment– The patient is not admitted to stay overnight at a hospital or clinic; for example, going to an appointment with a doctor or therapist
- Psychiatrist— A doctor with special training in the treatment and diagnosis of mental conditions; can prescribe medication but usually can’t provide therapy
- Psychotherapy— The therapeutic treatment of mental illness, sometimes called “talk therapy,” wherein feelings, thoughts, and behaviors are explored; there are many types of psychotherapy, like cognitive behavioral therapy, dialectical behavior therapy, ect.
- Psychologist— Has an advanced degree in psychology, can diagnose mental conditions and provide individual and group therapy
- Insurance– This describes how the provider accepts payment. For example, if it lists “Medicare, Medical Assistance, Blue Cross Blue Shield, Cigna” the provider will accept payment from those programs or companies. Below are more terms used to describe payment methods.
- Self-pay– You pay the provider directly, instead of going through an insurance company.
- Sliding-fee scale–Providers set the price of their services based upon the financial situation of their patients. If you cannot afford a provider’s normal fee but they have listed “sliding-fee scale” for insurance, they are willing to work with you to accommodate your financial ability.
- In-network– The provider contracts with an insurance company and provides care to its clients; those with private insurance will pay less to visit an in-network provider than an out-of-network provider. For example, if a provider lists “Blue Cross Blue Shield” for insurance in the directory, they are an in-network provider for that company.
- Out-of-network– The provider does not have an “in-network” relationship with insurance companies, but insurance companies will reimburse you for a portion of the cost of their services. For example, if you visit an out-of-network provider, you may pay the therapist’s fee up front, and your insurance company will later reimburse you for a certain percentage of the cost.
- Evidence-based practice— Methods of treatment that are supported by research, clinical expertise, and patient characteristics; Cognitive Behavioral Therapy and Dialectical Behavior Therapy are examples of evidence-based treatment options
The Howard County Network of Care for Mental/Behavioral Health is another way to find a mental health professional. The Network of Care is an online information portal of community health services, substance use treatment programs, and resources for people with developmental disabilities. Click this link to search for providers offering Adolescent/Youth Counseling by zip code!
Suicide is a serious public health problem that affects many young people. Suicide is the second leading cause of death for youth between the ages of 10 and 24 (CDC, 2018).
Suicidal thoughts, much like mental health conditions, can affect anyone regardless of age, gender or background. In fact, suicide is often the result of an untreated mental health condition. However, the majority of people with mental illness will not die by suicide.
What are the risk factors?
Risk factors are issues in a young person’s life that increase the likelihood (risk) of them acting on suicidal thoughts. There are a number of things that may put a person at risk of suicide, including:
- A family history of suicide.
- Substance abuse – Drugs and alcohol can result in mental highs and lows that exacerbate suicidal thoughts.
- Intoxication – More than one in three people who die from suicide are found to be currently under the influence.
- A serious or chronic medical illness.
- Serious mental health conditions – Depression, anxiety disorders, bipolar disorder, and personality traits of aggression, mood changes, and poor relationships.
- Gender– Although more women than men attempt suicide, men are four times more likely to die by suicide.
- A history of trauma, abuse, and/or neglect.
- Prolonged stress.
- Age– People under age 24 or above age 65 are at a higher risk for suicide.
- A recent tragedy or loss.
What are the warning signs?
Warning signs indicate that someone may be thinking about suicide. If someone you know is showing one or more of these signs, don’t wait- get help immediately. It is especially important to get help if someone is exhibiting these behaviors in connection to a painful change, loss, or event. These warning signs include:
- Talking about wanting to die or to kill oneself
- Looking for a way to kill oneself
- Talking about feeling hopeless or having no reason to live
- Talking about feeling trapped or in unbearable pain
- Talking about being a burden to others
- Increasing the use of alcohol or drugs
- Acting anxious or agitated; behaving recklessly
- Sleeping too little or too much
- Withdrawing or feeling isolated
- Showing rage or talking about seeking revenge
- Displaying extreme mood swings
If you see these signs in yourself or someone else, reach out to someone you trust, a parent, friend, teacher, coach, or religious leader right away.
You can contact the Grassroots Crisis Intervention 24-Hour Crisis Hotline . Call at 410-531-6677 or visit www.grassrootscrisis.org for more information.
You can also call the National Suicide Prevention 24-Hour Hotline at 1-800-273-8255 or contact the Crisis Text Line: text HOME to 741-741
What are the protective factors?
Risk factors can be balanced out to a certain extent by the presence of protective factors. There are a range of protective factors that can help to reduce suicidal behavior, including:
- Strong, positive relationships with parents and guardians – feeling secure and supported
- Connections to other adults– teacher, coach, pastor, counselor
- Closeness to caring friends
- School safety
- Feeling a sense of belonging to something bigger than themselves – community, culture, religion, sports team
Did You Know…
Asking about suicidal thoughts or feelings won’t push someone into doing something self-destructive. In fact, offering an opportunity to talk about feelings may reduce the risk of acting on suicidal thoughts.
It is important to know how to start the conversation about suicide, what to say during the conversation, and how to seek help.
Starting the Conversation
First find a private place to talk where there will not be any distractions. Set aside time to have a conversation and find a comfortable place to sit.
Remember to approach the situation with care and with open ears. If you do not know what to say, try one of these opening lines:
- “I’m worried about you and would like to know what’s going on so I can help.”
- “Are you okay? I noticed that you’ve missed school/practice a few times.”
- “It seems like something is bothering you. Do you want to talk about what’s going on?”
- “Seems like you haven’t been yourself lately. What’s up?”
During the Conversation
It is important to give full attention to the individual when they are being open about how they are feeling. Remember to:
- Keep it casual and relax. Think of the conversation as a chat, not a therapy session.
- Listen carefully.
- Avoid fixing the problem for them.
- Ask open-ended questions to help them talk instead of responding with “yes” and “no.”
Let them open up at their own speed. Do not demand answers or force them to say anything that they are not ready to.
Assist the individual with getting the professional help that they need.
- Help them connect: assist with reaching out to a parent, teacher, counselor, hotline, or other mental health professional.
- Contact Grassroots Crisis Center Hotline: 410-531-6677
- Contact the National Suicide Prevention Hotline: 1-800-273-8255
- Contact the Crisis Text Line: text HOME to 741 741
Don’t give up. Stay available and keep offering help. Handle their trust with care. Follow up and keep checking in to see how they are doing.
For more tips on how to start the conversation, ask questions, listen, and connect to resources, check out Seize the Awkward.
Grassroots Crisis Intervention (Crisis/Suicide/Runaway/Shelter)
Grassroots operates a 24-hour crisis intervention and supportive counseling hotline. Callers may remain anonymous and may call for a variety of reasons including suicide, family and relationship problems, shelter needs, violent or threatening domestic situations, loneliness or depression, and chemical dependency issues, among others. The Hotline is available 24 hours a day, seven days a week.
6700 Freetown Rd, Columbia, MD 21044
National Suicide Prevention Hotline
The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.
Deaf or Hard of Hearing: 1-800-799-4889 or visit the website for the chatline.
Maryland Crisis Connect
Provides trained crisis counselors to assist individuals struggling with suicide, physical and sexual abuse, depression, stress, pregnancy, homicide concerns, eating disorders, sexual identity, running away, relationship problems, divorce, sexually transmitted infections, and school issues.
Call 2-1-1, press 1 or text your zip code to 898-211 or TXT-211
Crisis Text Line
Crisis Text Line is free, 24/7 support for those in crisis. Text 741741 from anywhere in the US to text with a trained Crisis Counselor. Crisis Text Line trains volunteers to support people in crisis.
Text 741 741
Help For MD Youth
Help4MDYouth is a free, confidential hotline and chatline for Maryland youth who are going through a hard time or thinking about suicide, or are concerned about someone else. Use the online chatline Monday-Friday 4PM-9Pm or call the hotline 24/7 at 1-800-422-0009.
Howard County Resources
Howard County Health Department Behavioral Health Navigation Referral
Need help finding a therapist, psychiatrist, substance use treatment provider, or other behavioral health resources? Fill out this online form. A Behavioral Health Navigator will help you decide which services best meet you need, connect you to community services and resources, and follow-up on the outcome of the referral.
Howard County Behavioral Health Directory for Youth
A list of behavioral health providers that serve youth in Howard County. Go to How to Get Help for tips on navigating this guide.
Howard County Network of Care
A resource for individuals, families and agencies concerned with behavioral health. Regardless of where you begin your search for assistance with behavioral health issues, the Network of Care helps you find what you need – it helps ensure that there is “No Wrong Door” for those who need services.
NAMI Howard County
NAMI Howard County welcomes your call to help you find local resources and access mental health services. NAMI offers free peer support groups for people living with mental illness and their loved ones, as well as free education programs.
9650 Santiago Road, Suite 1
Columbia, MD 21045
The Horizon Foundation
As the largest independent health philanthropy in Maryland, the Horizon Foundation works to improve health and wellness for everyone who lives or works in Howard County. The Horizon Foundation offers mental health grant opportunities, an annual Mental Health Film Festival, and additional advocacy efforts. Check out their Emotional Support Human campaign for ways to check in on the mental health of your loved ones.
10221 Wincopin Circle, Suite 200
Columbia, MD 21044
Suicide Prevention Trainings
If you want to learn more about suicide prevention, mental health, how to ask a friend if they are thinking about suicide, and what to do in a crisis, attend a suicide prevention training. There are many different programs for youth, family members, and community members, and many are offered to Howard County residents for free! Click here for a calendar of upcoming mental health and suicide prevention trainings and events.
National Alliance of Mental Illness (NAMI)
The nation’s largest grassroots mental health organization, NAMI has great resources about mental health conditions, warning signs and symptoms, treatments, peer support networks, as well as platforms for education and advocacy.
Active Minds is a national leader in youth mental health advocacy and suicide prevention, with chapters at high schools and colleges across the country (including in Howard County! ). Visit their website for resources about mental health conditions, warning signs and symptoms, getting help, and how to help a friend. Visit your high school’s website or ask the student services office to see if your school has an Active Minds chapter and get involved!
American Foundation for Suicide Prevention (AFSP)
AFSP is a national voluntary health organization that empowers people affected by suicide through research, education, and advocacy. Visit their website for resources for those with mental conditions, survivors of suicide, and to learn about their advocacy efforts.
The Jed Foundation
Offers mental health and emotional well-being resources specific to young adults. Check out their guide to Help a Friend in Need Over Facebook and Instagram.
Provides one-stop access to U.S. government mental health information, with specific resources for young adults.
If you are concerned about the mental health of a young adult in your life, here are some resources to help you start a conversation and get connected to help. If you or someone you know is in immediate danger, call 911 or Grassroots Crisis Intervention Center at 410-531-6677 or visit the Resources for Teens page for more options.
Howard County Department of Health Bureau of Behavioral Health
Visit the website to explore the Bureau of Behavioral Health’s resources, programs and services, and to get connected to help. If you need help finding a therapist, psychiatrist, substance use treatment provider, or other behavioral health resources for yourself or a family member, fill out the HCHD Behavioral Health Navigation Services online form.
The CARE Line for Howard County Families
Child and Adolescent Resources and Education (CARE) for Howard County Families is a free service provided by the Howard County Office of Children and Families, with the support of Howard County Department of Community Resources and Services, the Howard County Local Children’s Board, Maryland State Department of Education, Howard County Mental Health Authority and the Governor’s Office for Children. The CARE Line is a resource and referral service for behavior issues, special needs, mental health concerns, adolescent concerns, support groups, and more. Call 410-313-CARE (410-313-2273) or email: firstname.lastname@example.org. Visit the website for more information.
The Jed Foundation: What To Do if You’re Concerned About Your Teen’s Mental Health
JED is a nonprofit that protects emotional health and prevents suicide for teens and young adults. This conversation guide covers signs that your teen may need help, how to prepare for the conversation, what to do and say during the conversation, what to do if your teen refuses help, and how to follow up after the conversation.
Maryland Coalition of Families (MCF)
MCF helps families that care for someone with behavioral health needs by helping them navigate services and systems, giving them tools to advocate, and connecting families to each other. Visit the website to get one-to-one support through an MCF Family Peer Support Specialist.
NAMI Howard County
The Howard County affiliate of the National Alliance on Mental Illness offers support and education programs, as well as advocacy and stigmafree campaigns. Visit the website to join their support group for parents and caregivers of children and teens with a mental health issue.
Consumer Guide to Understanding Your Health Insurance Coverage for Mental Health and Substance Use Disorders
This guide by the Maryland Insurance Administration provides tips for selecting a health insurance plan, how to work with your insurance company during mental health emergencies, how your health plan works, and your rights when your health insurer will not pay for health care services.
Maryland Health Connection
Maryland’s official insurance marketplace, where you can compare and shop for plans, apply for Medicaid and the Maryland Children’s Health Program and more.
For a calendar of upcoming community events, click here. To request community-based trainings, presentations, materials, & information, click here.
December 1 – December 22
7:00 – 8:00 pm – Virtual Teen Support after a Suicide Loss – Closed group offered every Tuesday in December, registration required
7:00 pm – American Foundation for Suicide Prevention – Talk Saves Lives: An Introduction to Suicide Prevention – for individuals 18+